Credentialing

Credentialing for prospective dentists is performed according to standards that are similar to those promulgated by the National Committee for Quality Assurance.

The following credentials and qualifications are required for participation in our network:

Credentialing requirementsPrimary and/or secondary source verified through:
State license BODEX
DEA or Controlled Substance Certificate (except orthodontists) NTIS, Internet web site or hard copy
Graduation from accredited dental school BODEX, ADA Master File* or copy of certificate
Specialty training verification (if applicable) ADA Master File or copy of certificate
Professional liability insurance Copy of declaration page or binder
Controlled substance certificate (if applicable) BODEX, applicable state agency or copy of certificate
Application and Contract Both must be signed by the dentist
Malpractice and sanction history Provider narrative
Onsite dental facility assessment for all DHMO general dentists; onsite visits for DHMO specialists and PPO dentists performed as needed All Cigna Dental standards for dental facilities are verified onsite by trained network managers
Review of utilization (profiling) data from Cigna Dental's database Outliers reviewed by the regional dental directors for all PPO
Key:  
BODEX: State Board of Dental Examiners
NTIS: National Technology Information Services
DEA: Drug Enforcement Administration
NPDB: National Practitioner Data Bank
   
*The ADA master file is a directory published by the American Dental Association that shows dentists' school of graduation, specialties, and whether the dentist is a member of the ADA.
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